经喉罩全凭七氟醚吸入麻醉在小儿腹股沟疝手术中的应用

The Application of Laryngeal Mask Airway Combined with Sevoflurane Inhalation Anesthesia in Children undergoing Hernia Surgery

目的:观察经喉罩全凭七氟醚吸入麻醉在小儿腹股沟疝手术中的临床应用效果。方法:60例ASAⅠ-Ⅱ级择期行腹股沟疝囊高位结扎术的患儿随机分成喉罩-七氟醚组(实验组)和氯胺酮组(对照组)。实验组以七氟醚诱导后置入喉罩,经喉罩全凭七氟醚吸入维持麻醉,对照组以氯胺酮和异丙酚诱导和维持麻醉。比较两组血流动力学、呼气末CO2分压(PETCO2)、手术时间、苏醒时间、出室时间(在恢复室内停留时间)。记录术中和术后不良反应如体动反应、嗜睡、恶心呕吐等发生情况。结果:对照组在T3、T4、T5时点HR、BP均明显高于实验组相应时点(P<0.05)。实验组患儿苏醒时间和出室时间均明显低于对照组(P<0.05)。对照组体动反应和嗜睡发生率明显高于实验组(P<0.05)。实验组术后恶心发生率明显高于对照组(P<0.05)。结论:经喉罩全凭七氟醚吸入麻醉用于小儿腹股沟疝手术,术中经过更平稳,麻醉恢复更快,术中及术后不良反应少。

Objective：To observe the clinical effect of laryngeal mask airway（LMA） combined with sevoflrane inhala- tion anesthesia in children undergoing hernia surgery. Methods：Sixty children undergoing hernia surgery were randomly divided into the LMA-sevoflurane group（the experiment group, n = 30） and the k etamine group （the control group, n = 30）. The LMA was used in children in the experiment group were inserted with soon after the induction with sevoflurane inhalation,and maintained with sevoflurane inhalation. The children in the control group were induced and maintained with intravenous ketamine and propofol. The hemodynamics and PET CO2 during anesthesia, the operation time, the time to regain consciousness, and the time out of operation room were recorded. The intra operative and postoperative side effects were recorded. Results： HR and BP in the control group on T3 ,T4,T5 were higher than those in the experiment group（P（0.05）. The time to regain consciousness and the time out of operation room in the experiment group were shorter than those in the control group（P^0.05）. The ratios of body movement and drowsiness in the control group were higher than those in the experiment group（P＇~0.05）. The ratio of nausea in the experiment group was higher than that in the control group（P〈0. 05）. Conclusion： LMA combined with sevoflurane inhalation anesthesia in children undergoing hernia surgery provided more stable perioperative period, faster resumption and lower rate of occurrences of side effects.